Complaint Investigation Report

415601070-10-20-2023-14-AS-KHOS-CWVHF2-20231023060848

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SF COASTAL AC/SC , 851 TRAEGER AVE., SUITE 360

This is an official report of an unannounced visit/investigation of a complaint received in our office on

02/27/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230227091514

- Staff financially abused resident in care

- Staff did not adhere to the Admission's Agreement

- Staff do not ensure that resident's toileting needs are met

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the allegations received. LPA met with Katherine Tazawa and explained the purpose of today's visit.

During the course of the investigation documents were reviewed and interviews were conducted. Due to no further information being received LPA cannot determine if the allegations can be upheld. These allegations are unsubstantatiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.

Report is reviewed with Katherine Tazawa. Copy is provided. No citations are issued.